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BMC Emergency Medicine
Published in: BMC Emergency Medicine 1/2018

Open Access 01-12-2018 | Research article

Predictive value of quick surgical airway assessment for trauma (qSAT) score for identifying trauma patients requiring surgical airway in emergency room

Authors: Kei Hayashida, Shokei Matsumoto, Mitsuhide Kitano, Junichi Sasaki

Published in: BMC Emergency Medicine | Issue 1/2018

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Abstract

Background

A surgical airway is usually unpredictable in trauma patients. The aim of this study was to develop a predictable scoring system to determine the need for a surgical airway by using a database from a large multicenter trauma registry.

Methods

We obtained data from the nationwide trauma registry in Japan for adult blunt trauma patients who were intubated in the emergency department. Based on a multivariate logistic regression analysis in the development cohort, the Quick Surgical Airway Assessment for Trauma (qSAT) score was defined to predict the need for a surgical airway. The association of the qSAT with surgical airway was validated in the validation cohort.

Results

Between 2004 and 2014, 17,036 trauma patients were eligible. In the development phase (n = 8129), the qSAT score was defined as the sum of the three binary components, including male sex, presence of a facial injury, and presence of a cervical area injury, for a total score ranging from 0 to 3. In the validation cohort (n = 8907), the proportion of patients with a surgical airway markedly increased with increasing qSAT score (0 points, 0.5%; 1 point, 0.9%; 2 points, 3.5%; 3 points, 25.0%; P <  0.001). Multivariate analysis revealed that qSAT score was an independent predictor of surgical airway (adjusted OR, 3.19 per 1 point increase; 95% CI, 2.47–4.12; P <  0.0001). The qSAT score of ≥1 had a had a good sensitivity of 86.8% for predicting the requirement for surgical airway; while qSAT score of 3 had a good specificity of 99.9% in ruling out the need for surgical airway.

Conclusions

The qSAT score could be assessed simply using only information present upon hospital arrival to identify patients who may need a surgical airway. The utilize of qSAT score in combination with repeated evaluations on physical finding could improve outcomes in trauma patients.
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Metadata
Title
Predictive value of quick surgical airway assessment for trauma (qSAT) score for identifying trauma patients requiring surgical airway in emergency room
Authors
Kei Hayashida
Shokei Matsumoto
Mitsuhide Kitano
Junichi Sasaki
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Emergency Medicine / Issue 1/2018
Electronic ISSN: 1471-227X
DOI
https://doi.org/10.1186/s12873-018-0203-4

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